Diabetic Charcot's Arthropathy of the Wrist

Bayne, Omar; Lu, Erika J.

doi:10.1097/00003086-199812000-00016

Cited by 32 publications

(30 citation statements)

References 11 publications

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“…Neuroarthropathies are felt to be more common in weight-bearing joints, such as the knee, hip, foot, and ankle (1,4). The most common joints to be affected in diabetes mellitus are the tarsometatarsal and metatarsophalangeal joints, whereas the non-weight-bearing hand and wrist joints are rarely affected (1).…”

Section: Discussionmentioning

confidence: 99%

“…One theory, the ''neurotraumatic'' theory, postulates that the normal pain mechanism is deactivated by articular denervation, allowing repetitive trauma to occur (1). If the joint remains unprotected, it sustains rapid destruction, hemarthrosis, synovial thickening, and secondary ligament laxity (11).…”

Section: Discussionmentioning

confidence: 99%

“…If the joint remains unprotected, it sustains rapid destruction, hemarthrosis, synovial thickening, and secondary ligament laxity (11). The second, and less accepted, theory is the ''neurovascular'' theory, which postulates that the underlying neurologic changes lead to hypervascularity in subchondral bone (1). There may be extensive erosion of the bone, increased bone resorption, bone weakening, microfractures, and subchondral collapse and destruction of the joint (12).…”

Section: Discussionmentioning

confidence: 99%

“…Neuroarthropathies, also known as Charcot joints, have been commonly reported in medical and neurological conditions such as diabetic neuropathy, tertiary syphilis, congenital indifference to pain, leprosy, multiple sclerosis, peripheral nerve lesions, pernicious anemia, poliomyelitis, cerebral palsy, syringomyelia, and spinal cord injury (SCI) (1)(2)(3)(4)(5). The common factor is recognized as sensory deficit in the affected extremity (2).…”

Section: Introductionmentioning

confidence: 99%

“…Severe gross instability with the formation of a ball-and-socket pseudoarthrosis has been reported (5,7). Usual clinical manifestation of a neuroarthropathy is a painfree joint or mild discomfort, if any, and the symptom is disproportionately mild in relation to the degree of destructive joint changes seen radiographically (1).…”

Section: Introductionmentioning

confidence: 99%

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Neuroarthropathy of the Wrist in Paraplegia: A Case Report

Shem

2006

The Journal of Spinal Cord Medicine

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Background/Objective: Neuroarthropathy, also known as Charcot joint, is most commonly seen in the spine and other weight-bearing joints in individuals with spinal cord injury (SCI). It is rarely seen in the joints of the upper extremities because the pathophysiology of the neuroarthropathy is thought to be significant repetitive trauma such as with weight bearing in an insensate joint.Methods: Case report of neuroarthropathy in the wrist of a 46-year-old man with a 30-year history of T4 paraplegia caused by ependymoma. Results:The patient recently developed a nonpainful swelling in the left wrist, which had decreased sensation since the time of his initial SCI. Radiological evaluation showed marked degenerative changes consistent with neuroarthropathy. A magnetic resonance image of the spine showed spinal cord atrophy at the cervicothoracic junction.Conclusions: This case shows an unusual presentation of a neuroarthropathy in a wrist in an individual with functional paraplegia. Because the treatment options for neuroarthropathy in the upper extremity in individuals with SCI are limited, early diagnosis is crucial to implement conservative management before significant destruction of the joint occurs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Neuroarthropathy of the Wrist in Paraplegia: A Case Report

Shem

2006

The Journal of Spinal Cord Medicine

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Charcot's neuroarthropathy of the wrist in type 2 diabetes

Wilmot¹,

Jadoon²,

Olczak³

2008

Pract Diab Int

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Injuries Associated with Crutch Use: A Narrative Review

Manocha

MacGillivray

Eshraghi

et al. 2020

PM&R

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Crutches are commonly prescribed in physiatric settings to help offload the lower extremities. Crutch use, however, results in abnormal and repetitive weight-bearing through the upper extremities that may result in secondary injury. This narrative review investigates injury types and risk factors associated with crutch use in order to guide healthcare providers on injury prevention strategies. Medline, EMBASE, CINAHL, and the Cochrane Library were systematically reviewed for publications between 1950 and 2018 on neurological, musculoskeletal, or vascular complications associated with crutch use. Titles and abstracts (n = 2395) were screened by two authors. Sixty studies were eligible. Articles were reviewed for level of evidence, crutch type, participant characteristics, and injury characteristics. There were 42 axillary crutch studies, 12 forearm crutch studies, and 6 studies that did not specify crutch type. These studies incorporated 622 individuals, and most were case series or case reports (n = 54). Axillary crutch use was most commonly associated with axillobrachial arterial complications due to pressure from the axillary bar (n = 34). Forearm crutch use was most commonly associated with compressive neuropathies due to pressure from the forearm cuff (n = 6). Improper crutch fitting and/or use were identified as contributing factors to injury in 22 cases. Duration of crutch use and medical comorbidities also influenced the types of injuries seen. There are rare but potentially serious complications associated with crutch use. When prescribing crutches, clinicians should ensure they are properly fit, engage in appropriate gait training, be aware of common crutch-related injuries, and consider potential patient-specific injury risk factors in order to minimize injury risk.

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Diabetic Charcot's Arthropathy of the Wrist

Cited by 32 publications

References 11 publications

Neuroarthropathy of the Wrist in Paraplegia: A Case Report

Neuroarthropathy of the Wrist in Paraplegia: A Case Report

Charcot's neuroarthropathy of the wrist in type 2 diabetes

Injuries Associated with Crutch Use: A Narrative Review

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